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Biomedical subjects

W Rödiger

Publications and source records attributed to W Rödiger.

At least 37 records · Page 2Linked to original sources
PubMed1992

Rejection, herpesvirus infection, and Ki-67 expression in endomyocardial biopsy specimens from heart transplant recipients.

We examined 164 endomyocardial biopsy specimens from 29 patients who received an orthotopic heart transplant since 1984. Rejection was graded according to the Hannover classification. Non-isotopic in situ DNA hybridization was conducted on cryostat sections with biotinylated probes for herpes simplex virus, Epstein-Barr virus, and cytomegalovirus. Serial sections of 126 biopsies were investigated immunohistochemically for the presence of activated T lymphocytes and proliferating cells, with monoclonal antibodies against interleukin 2 receptors (CD 25) and Ki-67 antigen. Relations between rejection grades, presence of proliferating cells, and presence of herpesvirus DNA were determined for the total number of biopsies. For some patients correlation of these parameters was studied over time. Herpesviral nucleic acids were detected in 25% of all biopsies: 37% of biopsies with relevant rejection (grades A 2 or A 3; 39% of all biopsies) compared to 18% of biopsies graded A 0, A 1, or A 5 (61% of all samples) (P less than 0.01). 56% of the biopsies with infection showed relevant rejection as compared with only 33% of the uninfected. Ki-67 expression was found in 41% of all biopsies, mainly in infiltrating cells: 69% of biopsies with relevant rejection compared with 23% of cases of minor/no rejection (P much less than 0.001). Ki-67 expression was also associated with herpesvirus infection: 66% of infected biopsies contained Ki-67 positive cells compared with 33% of uninfected biopsies (P less than 0.001). Herpesvirus infection was usually observed within the interstitial cell population, which, in many cases, displayed a considerable Ki-67 expression, too. In few cases only, hybridization was unequivocally found in vascular wall cells or myocytes. Viral myocarditis does not only mimic graft rejection morphologically, but it may also affect the course of rejection, via induction of antigenic changes or direct injury of cardiac tissues. Virus infections may also elicit or aggravate obliterative coronary artery disease, and thus contribute to accelerated graft atherosclerosis.

Adult↗
PubMed1992

[Oxygen affinity and regeneration capacity of SAG-M and PAGGS-M stored erythrocytes].

In order to estimate the leftward shift of the oxygen dissociation curve of hemoglobin following storage of red blood cells (rbc) in the additive solutions SAG-M and PAGGS-M, respectively, we performed blood gas analyses after equilibrating the cells with a gas mixture containing 4% of O2 and 5% of CO2 at pH 7.4 and 37 degrees C. Additionally, we took advantage of these nearly physiological conditions to measure the recovery of the hemoglobin function in vitro. We observed a good correlation between 2,3-BPG and p50 (i.e. the oxygen tension, at which hemoglobin is half-saturated with oxygen). Within the first 3 weeks of storage, the 2,3-BPG content fell to one fifth of its original value, whereas the p50 declined from 26.6 to about 20 mm Hg. Compared to fresh cells, rbc stored for longer than 3 weeks will thus deliver 30% less oxygen to the myocardium. The rbc's ability to restore these parameters remained unchanged throughout 7 weeks of storage.

2,3-Diphosphoglycerate↗
PubMed1990

[Comparative measurement of oxygen uptake and cardiac output at rest and during stress--evaluation of a new monitor for continuous determination of oxygen uptake and carbon dioxide release].

A new device for the continuous monitoring of oxygen uptake and carbon dioxide delivery is presented, which is based on a continuous expired gas analysis using a paramagnetic oxygen and an infrared-absorption carbon dioxide sensor. To validate the results, data of measured oxygen uptake and cardiac output calculated by the Fick principle were compared to synchronous thermodilution measurements at rest and during exercise. Measurements were performed at rest on 18 patients, additionally 13 of the patients were exercised with either 25 W or 50 W workload. The results indicate, for both measurement series, a significant correlation (r greater than 0.95, p less than 0.001) and exemplify that the measurement of oxygen uptake by expired gas analysis permits a precise analysis of the cardiovascular transport function during exercise.

Adult↗
PubMed1987

[Functional imaging of blood flow velocity amd myocardial perfusion using the Fourier transform parameter].

In the past, the radiology of the cardiovascular system has consisted of angiographic investigations which only demonstrate morphology. The introduction of digital techniques into radiology has made possible the demonstration of pure morphology and beyond that, calculations which provide functional information. We demonstrate functional images which, by using Fourier transformations, provide information on blood flow and organ perfusion. In this way, it is possible to obtain important additional diagnostic information concerning the cardiovascular system, without imposing any further stress on the patient.

Blood Flow Velocity↗
PubMed1986

[Imaging of ventricular wall motion using venous DSA. A new method in radiologic cardiac diagnosis].

Until now, angiographical and nuclear medicine examination techniques for imaging left ventricular wall motion have been presenting with difficulties endemic to the methods themselves. For the first time in cardiological diagnostics, digital subtraction angiography (DSA) makes it possible to perform a fairly non-invasive examination with good spatial and temporal resolution. Functional analytic evaluation, however, still demands time-consuming, complicated post-processing. In this article we introduce a method that uses an additive window technique for the immediate generation of wall motion images.

Angiography↗
PubMed1984

[Arterial digital subtraction angiography for demonstrating aortocoronary venous bypasses].

We examined the patency of aortocoronary venous bypasses in 51 patients during the early postoperative phase by using non-selective contrast injection into the aorta with digital subtraction angiography. In all patients it was possible to evaluate the degree of patency by this method. The accuracy and value of this examination, as compared with other invasive and non-invasive methods, is discussed.

Adult↗
PubMed1984

[Functional images of the left ventricle using digital venous angiography].

Imaging and functional evaluation of the left ventricle are of great interest in cardiological diagnosis. So far, the left ventricle has been imaged by laevocardiography or by a nuclear medicine method (gated blood pool, first pass). The limited spatial and temporal resolution of nuclear methods and the invasiveness of selective laevocardiography are well known disadvantages of these techniques. With special software and hardware, it is possible to obtain functional images of the left ventricle by means of intravenous contrast injection; these provide definitive information concerning local myocardial contraction patterns.

Angiography↗
PubMed1983

[Value of echocardiography in the preoperative diagnosis of acute bacterial endocarditis].

Open-heart surgery was performed in 26 of 56 patients with acute bacterial endocarditis seen in three years. Non-controllable infection, cardiac failure or embolism were the indications for operation. In all instances pre-operative invasive angiographic diagnosis was dispensed with, indications being based entirely upon clinical findings plus the results of M-mode or cross-sectional echocardiography. In 22 of the 26 patients the pre-operative echocardiographic diagnosis coincided with the intra-operative one. In the other four patients the pre-operative echocardiographic findings were incomplete, but no surgically important information had been missed.

Adult↗
PubMed1983

[Cause of pulmonary disorder following sclerosing therapy].

In order to elucidate pulmonary changes after sclerotherapy of esophageal varices animal experiments were performed. Polidocanol was injected into the submucosa of the distal esophagus and into a branch of the pulmonary artery. The submucous infiltration of the lower esophagus often causes congestive pulmonary alterations near the injection area. The subsequent disturbances of gas exchange as well as the negative inotropic effect of Polidocanol demands therapy in a number of cases.

Animals↗
PubMed1982

The reliability of echocardiography in preoperative diagnostics of bacterial endocarditis.

During a period of 4 years, 32 patients with acute bacterial endocarditis were admitted for cardiac surgical intervention. Uncontrollable infections, heart failure or embolism presented indications for the operation. In all cases, a preoperative, invasive angiography diagnostic was abandoned. The indication for surgical intervention was based on clinical criteria as well as the findings of one-dimensional or two-dimensional echocardiography. In 26 out of 32 patients who underwent surgical intervention, the preoperative echocardiography findings were in agreement with the intraoperative findings. In the remaining 6 patients, the preoperative echocardiographic findings were incomplete; in 2 cases particularly, it is important to note that an aneurysm of the ascending aorta had been missed. In view of these findings and results, we think that in acute bacterial endocarditis, the combined use of one- and two-dimensional echocardiography together with clinical findings can replace preoperative hemodynamic diagnostics.

Adult↗
PubMed1981

[Perioperative complete right bundle branch block after aorto-coronary bypass surgery (author's transl)].

In 322 patients undergoing isolated coronary artery bypass grafting, the possible factors responsible for the development of intraventricular conduction disturbances were investigated. In 18 patients (5.6%), complete right bundle branch was observed perioperatively, 2 of whom also demonstrated left anterior hemiblock. Left bundle branch block, either complete or incomplete, was not observed. Patients demonstrating perioperative complete right bundle branch block were further characterized by the finding that 14 of 18 (77.7%) had preoperative inferior wall infarction as opposed to only 34% in the remaining 304 patients. Fifteen of the 18 patients (83.3%) had prolonged aortic cross-clamp times in contrast to only 37.5% of the remaining patients. Three-vessel disease, present in 16 of the 18 (88.9%) patients, was less frequently present (56.2%) in those in whom complete right bundle branch block did not develop perioperatively. Application of the chi 2-test showed significant differences in all of the latter variables. The perioperative onset of complete right bundle branch block may be due to several factors. The results of this study indicate that the extent of scar tissue and arteriosclerotic changes as well as the ischemic time during surgery may play a decisive role. In ten of the patients, the perioperatively-incurred complete right bundle branch block was irreversible. Postoperative angiographic studies revealed no relationship between block development and graft occlusion.

Adult↗
PubMed1979

Hemodynamic changes following ventricular aneurysmectomy during the first three postoperative days.

One hundred twenty-eight patients underwent left ventricular aneurysmectomy; in 78 cases the procedure was combined with either aortocoronary bypass or valve replacement. In 7 patients undergoing isolated aneurysmectomy the influence of atrial pacing on various hemodynamic parameters was studied immediately postoperatively and on the first, second and third postoperative days. Until a certain point, increase in heart rate resulted in decrease of left ventricular filling pressure and increase of cardiac output, while systemic pressure changed only slightly. For each patient and each day the optimal heart rate as well as the optimal point of the Starling curve in these patients was found at extremely low filling pressures Kirklin's scheme of therapy may be limited in these patients. Therefore, in low cardiac output syndrome, left ventricular filling pressure should only be increased after the optimal heart rate is selected by atrial stimulation.

Heart Aneurysm↗
PubMed1978

[Preoperative localization of myocardial areas requiring revascularization in coronary artery disease (author's transl)].

At the time of preoperative coronary angiography in 44 patients left ventricular angiograms immediately after high frequency stimulation and after administration of nitroglycerin were performed. For interpretation we used the shortening (in percentage) of 8 vertical semi-diameters and of longitudinal axis in biplane angiograms. The data found in 15 healthy persons were used for comparison. Looking at the rate of shortening after high frequency stimulation myocardial areas endangered by hypoxia could be unmasked. By giving nitroglycerin thereafter we were able to differentiate between reversibly and irreversibly damaged areas. In 7 patients this has already been proven by postoperative examination. In preoperatively reversibly damaged myocardial areas no hypokinesis could be observed any more after successful revascularization. In contrast there was no improvement seen in preoperatively irreversibly damaged areas in spite of graft patency. The described preoperative angiography-test allows: 1. to unmask myocardial areas endangered by hypoxia. 2. to differentiate preoperatively between reversibly and irreversibly damaged areas. 3. more precise indication as well as better control of the results of revascularization.

Coronary Angiography↗
PubMed1978

[The role respiratory acidosis in the development of acute pancreatitis (author's transl)].

The effects of respiratory acidosis on the pancreas were studied in 25 Wistar rats. Ligation of the duct combined wiht respiratory acidosis resulted in the development of acute pancreatitis. In explantation of the results it is suggested that exhaustion of the buffering capacity causes a dramatic fall in pH of the pancreatic juice. The clinical relevance of findings is discussed.

Acidosis, Respiratory↗
PubMed1978

[Cardiocirculatory arrest due to hyperkalaemia following i.v. Imbretil for muscular relaxation (author's transl)].

The muscle relaxant Imbretil was investigated in 10 patients for initiating anaesthesia and for a prolonged artificial ventilation. In 50% of the patients a rather quick and drastic rise of the serum potassium-level was found. A cardiac arrest occurred in one patient due to a hyperkalaemia but fortunately was reversible. Consequently we do not use Imbretil in our Hospital anymore. Today better and less dangerous drugs are available instead--Imbretil must be placed as an obsolete drug.

Adjuvants, Anesthesia↗